Circulating thyroid hormones and clinical parameters of heart failure in men

Heart failure (HF) is a multiple hormonal deficiency syndrome which includes alterations in the serum concentration of thyroid hormones (TH). This cross-sectional study enrolled 215 male patients hospitalised for acute HF. Data on cardiovascular risk factors, chronic medications, cardiac function assessed by echocardiography, and clinical parameters of HF were prospectively collected. The independent predictive association of TH with all investigated parameters of the HF severity were assessed. The patient’s mean age was 74.4 years, 57.2% had arterial hypertension, 54.0% were consuming alcohol, and 42.3% were diabetics. Multivariate analysis revealed that total triiodothyronine (TT3) was an independent predictor of greater left ventricular ejection fraction (LVEF; β = 0.223, p = 0.008), less progressed left ventricular diastolic dysfunction (LVDD; β = − 0.271, p = 0.001) and lower N-terminal pro-brain natriuretic peptide (NT-proBNP; β = − 0.365, p < 0.001). None of the TH other than TT3 was associated with LVDD or NT-proBNP, whereas free triiodothyronine (β = − 0.197, p = 0.004), free thyroxine (β = − 0.223, p = 0.001) and total thyroxine (β = − 0.140, p = 0.041) were inversely associated with LVEF. The present study suggests that, among TH, serum TT3 level is most closely associated with echocardiographic, laboratory and clinical parameters of the severity of HF in men.


Supplementary Table
The normality of data distribution was tested using the Kolmogorov-Smirnov test.

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Multiple regression analysis for the predicting association of TT3 levels and other clinical factors with NYHA class.

Table S3 .
Multiple regression analysis for the predicting association of TT3 levels and other clinical factors with HF duration.

Table S4 .
Correlation between echocardiographic parameters of cardiac function, heart failure clinical parameters, and thyroid hormones other than TT3.

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Multiple regression analysis for the predicting association of TSH levels and other clinical factors with HF duration.

Table S6 .
Multiple regression analysis for the predicting association of TSH levels and other clinical factors with left ventricular ejection fraction.

Table S7 .
Multiple regression analysis for the predicting association of TSH levels and other clinical factors with left ventricular diastolic dysfunction.

Table S8 .
Multiple regression analysis for the predicting association of TSH levels and other clinical factors with NT-proBNP levels.

Table S9 .
Multiple regression analysis for the predicting association of TSH levels and other clinical factors with NYHA class.

Table S10 .
Multiple regression analysis for the predicting association of fT3 levels and other clinical factors with left ventricular ejection fraction.

Table S11 .
Multiple regression analysis for the predicting association of fT4 levels and other clinical factors with left ventricular ejection fraction.

Table S12 .
Multiple regression analysis for the predicting association of TT4 levels and other clinical factors with left ventricular ejection fraction.

Table S13 .
Multiple regression analysis for the predicting association of fT3 levels and other clinical factors with left ventricular diastolic dysfunction.

Table S14 .
Multiple regression analysis for the predicting association of fT4 levels and other clinical factors with left ventricular diastolic dysfunction.

Table S15 .
Multiple regression analysis for the predicting association of TT4 levels and other clinical factors with left ventricular diastolic dysfunction.

Table S16 .
Multiple regression analysis for the predicting association of fT3 levels and other clinical factors with NT-proBNP levels.

Table S17 .
Multiple regression analysis for the predicting association of fT4 levels and other clinical factors with NT-proBNP levels.

Table S20 .
Multiple regression analysis for the predicting association of TT4 levels and other clinical factors with NYHA class.Statistically significant (p<0.05).†, ‡ ß and p-values were obtained from the multiple regression analysis.TT4: total thyroxine, NYHA: New York Heart Association, HF: heart failure, BMI: body mass index, MI: myocardial infarction, ACEI: angiotensin-converting enzyme inhibitor, ARB: angiotensin II-receptor blocker. *